Many people tend to confuse two very different disorders: Tic Nervous Disorder and Obsessive Compulsive Disorder (OCD). This is due to the similarity in the repetitiveness of the behaviors in both cases, but it is worth getting to know them better, in order to identify, with greater certainty, what kind of problem we are talking about.
What is Tic?
According to the DSM IV, which is a Diagnostic and Statistical Manual of Mental Disorders, a tic can be understood by its predominant characteristic of being an involuntary movement. In this sense, we can understand tic as a movement of the body over which we have no control, for example: a blinking eye, a muscle movement, a recurrent vocalization, etc. Thus, they can be divided between motor and vocal tics.
Every type of tic is directly associated with stress and anxiety conditions. Sudden changes in a child's routine, for example, can generate a response like a tic. As they appear, tics tend to spontaneously disappear after a certain period of time (12 months on average). A very curious feature of Tics is that during activities that require concentration or during sleep, these movements decrease significantly. It is important to emphasize, then, the ineffectiveness of methods such as paying attention to tics or reprimanding them, since, being a movement involuntary, lack of control over this behavior that is being repressed can only increase anxiety and stress. Some authors argue, for example, that the best way to deal with tics is to ignore their occurrence, seeking to understand the reasons that led to the development of a response like this.
Although most tics disappear spontaneously, there are some cases where the tic becomes chronic. When the condition worsens and persists for more than a year, it can be said that it configures what we know as Gilles de la Tourette Syndrome, a disorder associated with numerous stressful situations and which are configured as a serious difficulty in relationship, attention and concentration that, unlike tic, requires intervention and treatment skilled.
What is OCD?
OCD is considered an anxiety disorder, whose diagnosis is basically focused on rituals and obsessions. According to the DSM IV, the diagnosis of OCD necessarily implies the presence of obsessions and compulsions. To be considered obsessions, thoughts must meet four criteria:
- Thoughts should be persistent, intrusive, inappropriate and recurrent that cause anxiety and discomfort.
- Differentiate from a simple exaggerated preoccupation with real life problems.
- Thoughts that the person constantly tries to ignore or neutralize with other thoughts or actions.
- They are impulsive and obsessive thoughts that the person recognizes as products of their mind and not as something external.
Compulsions, on the other hand, are understood as being of two types: repetitive behaviors of response or prevention. The first are those that the person performs in response to the obsession, obeying the rules he created for himself. The second comprises behaviors that have the function of preventing discomfort or some event that may cause this discomfort generated by anxiety. Compulsions can be several actions: washing hands repeatedly, checking, counting, repeating words, etc.
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There are still important features as to the course of development of obsessions and compulsions. In order to diagnose OCD it is necessary that, at some point, the person becomes aware of the exaggeration of their actions. It is also necessary that these behaviors are, in some way, significantly compromising the the person's life, interfering, for example, in their social life, the performance of their work or studies. Finally, it is important to remember that to be considered OCD, the behaviors cannot be the result, for example, of the use of drugs or other substances.
Although it seems quite complex, the diagnosis of OCD is not that difficult, since it is evident how much obsessions and compulsions disrupt a person's life. Many people are embarrassed to talk about compulsive behaviors or are unaware of the scope of the negative consequences of such repetitions. Treatment involves psychological and, in more specific cases, pharmacological follow-up, mostly aimed at controlling anxiety.
Why do people confuse Tic and Toc so much?
As we discussed, in both cases the presence of repetitions may be the character that leads to confusing the two disorders. It is important to emphasize, therefore, the difference in origin and unfolding in the cases of tics and OCD. In the first, the origin can be any stressful situation, of which the person is not aware, generating involuntary motor or vocal behavior and without function. In the case of OCD, the person is aware of the exaggeration of their behaviors, but these have the function of reducing anxiety, taking the focus of thought away from obsessions.
How to find out more?
An interesting strategy is to compare characters from two movies, one with OCD and one with tic. The film Best Impossible (As Good as It Gets - 1997) tells the story of Melvin Udall (Jack Nicholson), a writer with Obsessive Compulsive Disorder. already the movie The Class Leader (Front of The Class – 2008) tells the story of Brad Cohen (Jimmy Wolk), who has Tourette's Syndrome.
Juliana Spinelli Ferrari
Brazil School Collaborator
Graduated in Psychology from UNESP - Universidade Estadual Paulista
Brief psychotherapy course by FUNDEB - Foundation for the Development of Bauru
Master's Student in School Psychology and Human Development at USP - University of São Paulo